Halo-shape technique for leadless pacemaker implantations: A case report.
Kohki Nakamura1, Takehito Sasaki1, Kentaro Minami1
1Division of Cardiology, Gunma Prefectural Cardiovascular Center, 3-12 Kameizumi-machi, Maebashi City, Gunma, 371-0004, Japan.
Indian Pacing and Electrophysiology Journal
|October 19, 2020
Summary
A novel halo-catheter technique enabled successful leadless pacemaker implantation in a patient with severe spinal curvature. This method offers an alternative for challenging cases where conventional approaches fail.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Cardiology
Background:
- Complete atrioventricular block necessitates pacemaker implantation.
- Leadless pacemakers offer advantages but can be challenging to deploy in patients with complex anatomy.
- Transvenous lead extraction due to infection preceded the need for a new pacemaker.
Observation:
- A 92-year-old woman with severe scoliosis and kyphosis presented anatomical challenges for standard leadless pacemaker delivery.
- Conventional gooseneck-shaped catheter manipulation was unsuccessful in reaching the target septal or apical region.
- A modified halo-catheter shape was employed to navigate the delivery catheter.
Findings:
- The halo-catheter technique successfully directed the leadless pacemaker to the infero-basal right ventricular septum.
- The implantation was achieved without complications, demonstrating good device parameters.
- This approach proved effective in a patient with extreme anatomical limitations.
Implications:
- The halo-catheter technique represents a viable alternative for leadless pacemaker implantation in anatomically challenging patients.
- This method may improve success rates for leadless pacemaker procedures when standard techniques are unsuccessful.
- Further research into modified catheter techniques could expand the applicability of leadless pacing.
